This study explored the impact of various label information (extrinsic attributes) and sociodemographic and attitudinal factors (intrinsic attributes) on Brazilian consumer choices, using simulated traditional and plant-based muçarela cheese as the model product. The research was conducted in two phases: the first involved a structured questionnaire assessing attitudinal dimensions such as Health Consciousness, Climate Change, Plant-based Diets, and Food Neophobia, along with sociodemographic data collection. The second phase comprised a discrete choice experiment with (n = 52) and without (n = 509) eye tracking. The term \"Cheese\" on labels increased choice probability by 7.6% in a general survey and 15.1% in an eye tracking study. A prolonged gaze at \"Cheese\" did not affect choice, while more views of \"Plant-based product\" slightly raised choice likelihood by 2.5%. Repeatedly revisiting these terms reduced the choice probability by 3.7% for \"Cheese\" and 1% for \"Plant-based product\". Nutritional claims like \"Source of Vitamins B6 and B12\" and \"Source of Proteins and Calcium\" boosted choice probabilities by 4.97% and 5.69% in the general and 8.4% and 6.9% in the eye-tracking experiment, respectively. Conversely, front-of-package labeling indicating high undesirable nutrient content decreased choice by 13% for magnifying presentations and 15.6% for text. In a plant-based subsample, higher environmental concerns and openness to plant-based diets increased choice probabilities by 5.31% and 5.1%, respectively. These results highlight the complex dynamics between label information, consumer understanding, and decision-making.

UNASSIGNED: To estimate the preferences of patients with asthma and asthma-treating clinicians for attributes of biologic treatments, to compare patients\' and clinicians\' preferences, and to better understand the reasons for their preferences.
UNASSIGNED: Adults with moderate-to-severe asthma and clinicians who treat asthma in the US completed a cross-sectional, online survey including a discrete choice experiment (DCE) that consisted of seven attributes spanning treatment efficacy, risk and convenience. Marginal utilities were estimated using a mixed logit model, and relative attribute importance scores calculated. Clinicians were also asked about the value of biomarker agnostic biologic treatments. The survey was followed by qualitative interviews targeting a sub-sample of survey participants, in which the rationale behind their survey responses was discussed.
UNASSIGNED: In the DCE, both patients and clinicians placed the most importance on exacerbation and hospitalization rate reduction, and risk of injection site reaction. Patients valued location of administration more than clinicians. Rationale for individual-level preferences varied, with patients and clinicians reporting their preference depended on event frequency and anticipated quality of life impacts. Clinicians mentioned compliance and financial impacts, while patients mentioned personal experience, particularly around site reactions. Most patients and clinicians would value a biomarker agnostic asthma treatment.
UNASSIGNED: Asthma treatment preferences are largely driven by treatment efficacy and minimizing the risk of site reactions, although preferences differ between patients and clinicians across other attributes, highlighting the need for shared decision-making and individualized care.

Aim: Patient preferences for the features of targeted chronic lymphocytic leukemia (CLL) therapies may differ. Materials & methods: A discrete-choice experiment (DCE) survey was administered to 229 respondents recruited through the CLL Society. Results: Respondents placed most importance on increasing the chance of progression-free survival (PFS) at 2 years from 70 to 90% and confirming results with measurable residual disease (MRD) testing instead of routine testing. Respondents also preferred daily oral administration over intravenous infusion every 4 weeks, fixed-duration treatments over treat-to-progression treatments and treatments with lower side effect risks. Reducing risk of tumor lysis syndrome was least important relative to changes in other attributes. Conclusion: The combination of improving PFS combined with confirming results using MRD testing was more important than changes in all other study attributes included in the DCE. Results from this study can help inform shared decision-making when selecting therapies for CLL.
Several targeted treatments are available for people with chronic lymphocytic leukemia (CLL). These treatments target specific proteins present in CLL cancer cells. They differ in how long they keep cancer from progressing, how the results are measured and the side effects they cause. Some targeted CLL treatments are taken as a daily pill, and others are given by intravenous infusion. Some targeted treatments are given for a fixed amount of time, and others are given until CLL progresses. We surveyed 229 US patients with CLL to understand what features they most value in a targeted CLL treatment. Survey participants were recruited through the CLL Society, a nonprofit organization devoted to education, support, advocacy and research for the CLL community. Survey results indicated that participants placed the most importance on increasing the chance that the cancer would not progress after 2 years from 70 to 90% and confirming results with measurable residual disease testing (which can detect minute levels of leukemia cells) instead of routine testing. Participants also preferred taking a pill every day over receiving an intravenous infusion every 4 weeks and preferred treatments given for a fixed amount of time over treatments given until CLL progresses. Participants preferred treatments with lower chances of tumor lysis syndrome (a potentially organ-damaging condition that may result following treatment), irregular heartbeat and fatigue. It is important for doctors to understand the treatment features that matter to people living with CLL so that they can work with patients individually to choose the right treatment.

Values that accompany generic health measures are typically anchored at 1 = full health and 0 = dead. Some health states may then be considered \'worse than dead\' (WTD) and assigned negative values, which causes fundamental measurement problems. In this paper, we challenge the assumption that anchoring values at \'dead = 0\' is necessary for quality-adjusted life year (QALY) estimation. We summarise the role of \'dead\' in health state valuation and consider three critical questions: (i) whether the measurement properties of health state values require \'dead\'; (ii) whether \'dead\' needs to be valued relative to health states; and (iii) whether values for states WTD are meaningful or useful. We conclude that anchoring 0 at dead is not a requirement of health status measurement or cost-effectiveness analysis. This results from reframing QALYs as the relevant unit of measurement and reframing values as being derived from QALYs rather than the reverse.

Safety-in-Numbers (SiN) implies that the risk of collision per road user is less when there are more road users. Although the available literature has confirmed the existence of SiN as an objective measure of safety, the effect on perceived safety, especially in the context of bicycle riders, has received much less attention. This study investigates the SiN effect on the perceived safety of bicycle riders that influences route choice behavior. A stated preference survey was performed in the South Delhi district of Delhi. The effect of attributes like posted speed limit, the volume of motorized traffic, bicycle infrastructure, and bicycle traffic/ crowding on route choice behavior was investigated. A binary logit model was developed to quantify the effect of these attributes on route choice. The results indicate that, in general, riders prefer routes with more bicycle traffic, hence validating SiN. But the effect does not always hold. For some riders, in the presence of dedicated bicycle infrastructure, when the perceived safety is higher, the presence of more bicycle traffic acts as crowding and demotivates riders to choose that route. The study also reveals that riders prefer routes with a low volume of motorized traffic and dedicated bicycle infrastructure. The outcomes suggest that a policy that encourages infrastructural development to provide lateral separation will encourage more people, hence increasing bicycle mode share as well as the perceived safety of riders.

The COVID-19 pandemic had a significant impact on travel mode choices in cities across the world. Driven by perceptions of risk and the fear of infection, the pandemic resulted in an increased preference for private vehicles and active modes and a reduced preference for public transit and ride-sourcing. As travel behavior and modal preferences evolve, a key question is whether the pandemic will result in long-term changes to travel mode choices. This study uses data from a web-based survey to examine the factors influencing mode choices for non-commuting trips in the post-pandemic era. Specifically, it uses stated preference data to develop a random parameter mixed logit model, which is used to compare the elasticity of key variables across different income and age groups. The results of the study highlight the influence of sociodemographic attributes and pre-pandemic travel habits on anticipated post-pandemic mode choices. Additionally, the results suggest that frequent users of private vehicles, public transit, and active modes are likely to continue to use these modes post-pandemic. Furthermore, the results highlight the potential for the perception of shared modes to influence post-pandemic mode choice decisions. The results of the study offer insights into policy measures that could be applied to address the increased use of private vehicles and reduced use of transit during the pandemic, while also emphasizing the need to ensure that certain segments of the population can maintain a sufficient level of mobility and access to transport.

OBJECTIVE: Patient preferences regarding thyroid nodules are poorly understood. Our objective is to (1) employ a discrete choice experiment (DCE) to explore risk tradeoffs in thyroid nodule management, and (2) segment respondents into preference phenotypes.
METHODS: DCE.
METHODS: Thyroid surgery clinic, online survey.
METHODS: A DCE including 5 attributes (cancer risk, voice concerns, incision/scar, medication requirement, follow-up frequency) was refined with qualitative patient and physician input. A final DCE including 8 choice tasks, demographics, history, and risk tolerance was administered to participants with and without thyroid disease. Analysis was performed with multinomial logit modeling and latent class analysis (LCA) for preference phenotyping.
RESULTS: A total of 1026 respondents were included; 480 had thyroid disease. Risk aversion was associated with increasing age (P < .001), female gender (P < .001), and limited education (P = .038), but not previous thyroid disease. Cancer risk most significantly impacted decision-making. Of the total possible utility change from thyroid nodule decision-making, 47.8% was attributable to variations in cancer risk; 20.0% from medication management; 14.9% from voice changes; 12.7% from incision/scar; and 4.6% from follow-up concerns. LCA demonstrated 3 classes with distinct preference phenotypes: the largest group (64.2%) made decisions primarily based on cancer risk; another group (18.2%) chose based on aversion to medication; the smallest group (17.7%) factored in medication and cancer risk evenly.
CONCLUSIONS: Cancer risk and the need to take medication after thyroid surgery factor into patient decision-making most heavily when treating thyroid nodules. Distinct preference phenotypes were demonstrated, reinforcing the need for individual preference assessment before the treatment of thyroid disorders.

Health programs/services are often bundled, allowing for both substitution and complementarity. We adapt Discrete Choice Experiments to capture bundling, with application to a case study of exercise and nutrition; complementarity arises due to the goal of improving health. Our contributions are (1) to present a menu-based choice experiment to explore bundling; (2) to analyse the menu-based data using an extension of the choice set generation model (GenL) to account for correlations between bundles and component singles. A nationally representative sample of 333 Australians chose between a nutrition program only; exercise program only; both nutrition and exercise programs; or their status quo. Overall, we show that by incorporating the menu choice task and introducing the combined alternative, we capture a significant portion of the population seeking both exercise and nutrition components. We estimate a latent class GenL model, and identify two latent classes: Class 1 preferred to choose programs on offer, and Class 2 was more price sensitive and had a stronger preference for staying with their status quo. We show in the post-estimation analysis that heterogeneity in preferences translates into heterogeneity in the way alternatives are bundled, indicating that the combined offering is appealing to specific classes of individuals who prefer bundling. By implementing the menu choice task, researchers and policymakers can effectively identify, cater to and influence the demand for combined exercise and nutrition options, leading to more targeted and impactful interventions in promoting healthier lifestyle choices.

Offshore wind development is in its nascent stages in the United States. Recent research indicates that the visual impacts of offshore wind farms are viewed negatively by the general population. This North Carolina application is the first US-focused discrete choice experiment that explicitly asks respondents to consider the positive local and global benefits from offshore wind development, such as job creation and greenhouse gas emission reductions, simultaneously with their visual impacts. We find significant willingness to pay (WTP) for reducing the visual impacts of offshore wind farms, and that the extent of disamenity varies in the population and with placement along developed tourist towns (as much as $783/year for three years) or preserved coastlines (as much as $451/year for three years). We also find that some preference classes value projects that create permanent jobs and reduce carbon emissions. We use our estimates of preferences for the positive and negative attributes to explore specific wind farm configurations and locations that could achieve positive consensus in a heterogenous population.

This systematic review aimed to synthesise evidence from discrete choice experiments (DCEs) eliciting preferences for virtual models of care, as well as to assess the quality of those DCEs and compare the relative preferences for different stakeholder groups. Articles were included if published between January 2010 and December 2022. Data were synthesised narratively, and attributes were assessed for frequency, significance, and relative importance using a semi-quantitative approach. Overall, 21 studies were included encompassing a wide range of virtual care modalities, with the most common setting being virtual consultations for outpatient management of chronic conditions. A total of 135 attributes were identified and thematically classified into six categories: service delivery, service quality, technical aspects, monetary aspects, health provider characteristics and health consumer characteristics. Attributes related to service delivery were most frequently reported but less highly ranked. Service costs were consistently significant across all studies where they appeared, indicating their importance to the respondents. All studies examining health providers\' preferences reported either system performance or professional endorsement attributes to be the most important. Substantial heterogeneity in attribute selection and preference outcomes were observed across studies reporting on health consumers\' preferences, suggesting that the consideration of local context is important in the design and delivery of person-centred virtual care services. In general, the experimental design and analysis methods of included studies were clearly reported and justified. An improvement was observed in the quality of DCE design and analysis in recent years, particularly in the attribute development process. Given the continued growth in the use of DCEs within healthcare settings, further research is needed to develop a standardised approach for quantitatively synthesising DCE findings. There is also a need for further research on preferences for virtual care in post-pandemic contexts, where emerging evidence suggests that preferences may differ to those observed in pre-pandemic times.